Abstract
Background: Although uncommon in children, abdominal tuberculosis (ATB) can be a life-threatening condition with a subset requiring emergency surgical intervention. This study aims to determine the presentation, surgical procedures performed, and outcomes in children affected by abdominal tuberculosis. Methods: A retrospective chart review of all children undergoing surgical intervention for ATB from July 2007 to December 2018 was conducted. Data were analyzed using SPSS version 22. Results: Of 340 children with a diagnosis of ATB seen at the Indus Hospital’s TB clinic, 14 (4%) underwent laparotomy. Females were affected more commonly (57%), with a mean age at presentation of 11 years (range 8-14). Nine children required laparotomy for documented perforation, while 5 had an intestinal obstruction. Most children (n=10) had an established diagnosis of ATB before the surgical intervention; 2 children had completed 6–9 months anti-tuberculous treatment (ATT) courses, while 8 children had been on ATT for a mean period of 2.5 months at the time of developing acute surgical symptoms. Diversion ileostomy was made in 64%. Postoperative complications included sepsis (n=4), wound infection (n=3), abdominal collection (n=2), enterocutaneous fistula (n=2), and abdominal wound dehiscence requiring formal closure (n=2). There were 4 mortalities (29%); 10 patients were discharged after a median in-hospital stay of 12 days (range 6-35) of which 6 with ileostomies underwent reversal after completion of the ATT course. Conclusion: ATB has high morbidity and mortality. Perforation and obstruction can occur during or after the completion of ATT. Management requires early recognition and surgical intervention as indicated.
Highlights
Tuberculosis (TB) is one of the top ten causes of death worldwide.[1]
Pakistan is ranked fifth among the high-TB burden countries worldwide [3] and correspondingly, have a high incidence of children suffering from abdominal tuberculosis (ATB).[4]
Children affected by abdominal tuberculosis frequently present to the pediatric surgery service; they are either referred from the pediatric TB clinic, or present to the emergency room with acute abdominal symptoms which are later determined to be secondary to TB, or sequelae of ATB
Summary
Tuberculosis (TB) is one of the top ten causes of death worldwide.[1] TB is a major cause of childhood mortality, and 95% of these deaths occur in developing countries.[1] An estimated 10% – 25% of affected children have an extrapulmonary disease (EPTB); abdominal TB (ATB) is the 6th most common extrapulmonary site reported.[2] Pakistan is ranked fifth among the high-TB burden countries worldwide [3] and correspondingly, have a high incidence of children suffering from ATB.[4]. Children affected by abdominal tuberculosis frequently present to the pediatric surgery service; they are either referred from the pediatric TB clinic, or present to the emergency room with acute abdominal symptoms which are later determined to be secondary to TB, or sequelae of ATB. Abdominal tuberculosis (ATB) can be a life-threatening condition with a subset requiring emergency surgical intervention. This study aims to determine the presentation, surgical procedures performed, and outcomes in children affected by abdominal tuberculosis
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
